Spine
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Combined prospective and retrospective. ⋯ The Threshold-Level method is highly sensitive and specific to deterioration in central motor function, and provides early warning of such an event. Conversely, in some cases the Presence-or-Absence method may fail to detect episodes of partial loss, and in other cases typically introduces a delay between the times when motor dysfunction begins to occur and when the response is lost (at which time an alarm is triggered). We conclude that use of the Presence-or-Absence alarm criteria for interpreting MEPs during surgery is often incompatible with the requirement for accurate and early warning of impending injury to central motor pathways, and should be avoided.
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Retrospective case series of 16 consecutive patients. ⋯ Scoliosis surgery is frequently necessary in PWS and is associated with high rate of complications. These are often related to specific features of this syndrome the surgeon should recognize and consider.
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This is a prospective observational study of erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) in a cohort of patients undergoing spinal surgery. ⋯ CRP is more applicable, predictable, and responsive in the early postoperative period compared with ESR. The postoperative kinetics of CRP derived in this study seems to be conserved regardless of operation, magnitude, or region. Knowledge of the kinetics allows assessment of the degree of difference between actual and expected values. Using a second rise or failure to decrease as expected for CRP is sensitive for infection. A negative test is reassuring that infection is unlikely.
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Case Reports
Postoperative Trichosporon asahii spondylodiscitis after open lumbar discectomy: a case report.
A case report of Trichosporon asahii spondylodiscitis. ⋯ We present the first case of T. asahii spondylodiscitis, which developed unexpectedly in a healthy woman at the site of an open lumbar discectomy. We successfully treated the patient with surgical debridement and 5 months of fluconazole therapy.
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This study assessed the relationship of the vertebral artery and the transverse foramens in the lower cervical spine by computer tomographic angiography (CTA) measurements. ⋯ Vertebral artery is in the medial part of transverse foramen. There is a relative "abundance space" for vertebral artery in transverse foramen.